I am now two days in to my second week of medical school. Unfortunately it is true; this process consumes your life and eliminates much of your free time. When you aren't in class, clinic or hospital, you are studying, and if you're not studying you are eating food or working out, and if you aren't doing those things, you feel guilty. As I write this I'm deciding which of the classes I have tomorrow that I'll make time to study for today, because I know I won't be able to cover them all. I'll do a quick skimming of the biochem lecture after writing this, then eat some food, then breeze through one of the cell bio lectures while riding the crowded T (metro/subway, which will be full of people leaving work and headed home) as I head to the free clinic I'm volunteering at. If there is any down time there, I'll consider reviewing some notes, but most likely end up talking with 2nd years and practicing blood draws, taking blood pressures and listening to heart and lung sounds... With that, it means that I won't go over any genetics and lack time to read for the second cell bio lecture I have tomorrow. Shucks... at least we have a 3-day weekend coming up!

Luckily, not all of school is hard science. Tuesday I work in the clinic, and Thursday we have patient interviewing. This is where I discovered that I never want to age past 30... it sounds terrible. The course gives us the opportunity to interview patients about their life, their experiences with the health care system and understand their medical history and current state of health. Many of the patients are of an elderly population, and it is simply amazing to hear all the medications they take, specialists they see, surgeries they've had, and other chronic and acute diagnoses that they've dealt with. I simply can't imagine having to keep track of all that for myself. When asked about their health, often the response is, "I feel great. I'm 83 and still staying active." Then after a few more in depth questions you come to find they recently visiting the emergency department for an injury, are taking a handful of medications for chronic illnesses, and are limited in what they are able to do in their day to day life due to surgeries or other diagnoses. It was incredibly eye opening to hear their stories and understand that its not a rarity to be so tied into the health care system as we age...
*Apparently the fastest growing population in the United States is currently that of 85+

On a much lighter note, the photo above is what I see after walking about 20 yards outside my building. It's a great way to start my day, walking to the T to go to school, a view like that can't hurt. For the sake of my sanity, I'm going to retire to study. I was told by a friend that they actually read this blog, so I promise I'll make an effort to write more entries.

Seattle is # 1

The first day of real class starts tomorrow. My first 1.5 hours of medical school will be hearing a patient's story about living with cystic fibrosis. After a week of orientation (to sum it up - going to a lecture hall, listening to Deans and instructors, then at night going out and partying... a lot... seriously, a lot.... the future doctors of America know quite well how to play hard... this week we'll see how hard we work) it will be important to have our first in-class experience not learning the biochemistry of our genes (that's at 10:30am tomorrow) but instead to hear someone's story. To hear what their life is like, and to better grasp the world through someone else's point of view. In my opinion, the ability to listen and take in someone's story is one of the most important skills and abilities that any physician can have. We are not treating a disease, but working with someone to better their health.

On an unrelated note: Seattle is number one... when it comes to best cities in the country to have a heart attack... This was something we learned when becoming CPR certified. Apparently a lot of people are CPR certified in Seattle, leading to higher survival rates when an event occurs out-of-hospital, than other cities. I was proud to hear that.

Hear is a quick run down of the first few steps of what we learned:
1. Check for responsiveness
2. Activate emergency response - send for help and get an AED (defibrillator)
3. If unresponsive open the airway - tilting head back and chin up
3. Look listen feel for breathing - If none, give 2 rescue breaths to see if airway is open (watch for chest rise)
4. Check for pulse
5. If no pulse, begin chest compressions and breathing (30 compressions to 2 breaths at 100 compressions a minute)
That's just the first couple steps, which vary depending on age and setting of the incident...

After completing the CPR training, I had the song "Staying Alive" stuck in my head because we learned that the beat of that song is roughly the pace at which you are supposed to perform chest compressions. You can also do it to the beat of "Another One Bites the Dust," which might be a bit dark for my liking... These songs are roughly 100bpm, which is the ideal pace for performing compressions.

Although we learned to include breaths while performing compressions (30 compressions : 2 breaths), we were told the guidelines will be changing to not include breaths and simply perform compressions at 100/minute. A few reasons are leading to this change: First, not many people are eager to put their mouth on the mouth of a stranger, that might mean less are willing to perform CPR. Secondly, taking breaks from performing compressions leads to less blood getting to where it needs to go. The pressure created in the heart from compressions increases as you perform them, and when you stop to give breaths the pressure drops and then takes time to build back up to an optimal level. So, instead of stopping, because a person has almost 8 minutes of oxygen reservoir in their body if compressions are continually administered, it becomes less necessary and sometimes detrimental to take breaks to give breaths.

Now, it's time to prep for lectures tomorrow. Here we go...

CPR

I'm currently taking an online course on how to perform CPR. The first half of the course we take an home, filled with reading and assessments, while the second half we perform a hands on assessment that we take at school during orientation next week.

Contrary to popular belief, slapping the patient is not listed as effective way to revive them when performing CPR... however, Ed Harris might disagree...

http://www.youtube.com/watch?v=UHkB1rJHEGA